Interpretive Summary: Cardiovascular disease are the single most prevalent cause of morbidity and mortality and dietary factors, such as alcohol, may decrease risk for these diseases. In a controlled diet study of 51 postmenopausal women, we determined the effect of moderate alcohol consumption (1 to 2 drinks/day) on risk factors of cardiovascular disease. Compared to the controlled diet with no alcohol, women consuming 1 drink/d exhibited a decrease in LDL cholesterol and a decrease in triglycerides. However, there was no additional decrease in either with an increase in ethanol to 2 drinks/d. HDL cholesterol increased with the addition of 1 drink/d compared to controls, and further increased with an increase to 2 drinks/d. These results suggest that consumption of 1 or 2 drinks/d by postmenopausal women decreases risk for cardiovascular disease as a result of an improved lipid profile; however with respect to LDL-, HDL cholesterol and TG, only HDL cholesterol is improved further when women consume 2 drinks/d compared to 1 drink/d. These data are important for postmenopausal women who are interested in making dietary choices that can decrease risk for disease, as well as health professionals and policy makers who provide recommendations concerning alcohol consumption.

Technical Abstract:
Moderate alcohol consumption (1-2 drinks/day) may decrease risk for cardiovascular diseases as a result of an improved lipid profile. However, there are few data from controlled feeding studies to support these observations in postmenopausal women. As part of a controlled diet study, 51 postmenopausal women each consumed 0, 15 and 30 g/d of ethanol for 8 weeks, in a randomized cross-over design. The control diet (0 g/d ethanol) composition was approximately 15%, 54%, and 31% of energy from protein, carbohydrate and fat, respectively. Energy from alcohol replaced energy from carbohydrate, and average replacement was 4.5% and 9% of energy for the 15 g/d and 30 g/d treatments, respectively. Compared to the controlled diet with no alcohol, women consuming 15 g ethanol/d exhibited a decrease in LDL cholesterol from 3.46 to 3.34 mmol/L (+/- 0.117 SEM, p=0.02) and a decrease in triglycerides from 1.43 to 1.34 mmol/d (+/- 0.071 SEM, p=0.02). However, there was no additional decrease in either with an increase in ethanol to 30 g/d. HDL cholesterol increased from 1.39 to 1.43 mmol/L (+/- 0.048 SE, p=0.04) with the addition of 15 g ethanol/d compared to controls, and further increased to 1.48 mmol/L with an increase to 30 g ethanol/d (p=0.008). ApoAI concentration increased and apoB concentration decreased after consumption of 30 g ethanol/d whereas apoAII concentration did not change. These results suggest that consumption of 1 or 2 drinks/d by postmenopausal women decreases risk for cardiovascular disease as a result of an improved lipid profile; however with respect to LDL-, HDL cholesterol and TG, only HDL cholesterol is improved further when women consume 2 drinks/d compared to 1 drink/d.